Ageing population crisis

[Cucumberpitta]

Medical intervention means we are living longer than ever before. We are spending a larger proportion of our lives dependent on care because we are disabled, in pain, and/or without mental capacity.

There are not enough carers because it's an undervalued role with shit pay.
There seems to be no planning by govt to prepare for this shift - there will literally not be enough carers or tax payers to look after the elderly.

Not to mention the questionable morality of preventing the death of someone for them to live in pain, doubly incontinent, immobile and confused; with insufficient care because there's just not enough funding for them.

People talk of the immigration crisis, climate crisis....

The percentage of elderly needing care is set to skyrocket and we can't even look after the current numbers properly.

What is going to happen?

@foxgoosefinch

Cucumberpitta - there are big differentials in birth rates between EU countries.

en.m.wikipedia.org/wiki/Ageing_of_Europe

euobserver.com/news/151844#:~:text=Eastern%20Europe%20is%20not%20only,anywhere%20else%20on%20the%20continent.&text=According%20to%20World%20Health%20Organization,reach%202.1%20billion%20by%202050.

Our European neighbours will need their working age citizens.

@foxgoosefinch no I don't, why is it relevant that countries like Ireland & Poland has younger populations? Are you just assuming young people from those countries want to move to the UK? over other European countries?

@BogRollBOGOF

Kind of ironic at all the effort made to "keep granny safe" in 2020 when the reality is that many old, frail people have had their quality of life massively eroded by being denied access to healthcare (especially when they can't access it remotely) which has accelerated the development and suffering of underlying conditions, by denying or reducing their contact with loved ones (especially if in a residential setting) and generally making them too fearful to maintain their previous routines. I'm not convinced that this has been a kindness to very elderly people.

One relative is approaching 90, lost the monitoring for her slow developing cancer, has ended up on the cusp of residential care, was unable to see her visiting grand children for the first time in two years because she could have one visitor for 30 mins (it will be over 2.5 years before we can reliably book travelling over again). Her condition has massively accelerated, and quality of life rapidly declined. Taking your chances on a short respiritory illness doesn't seem so awful in comparison to indefinite months/ years of pain, lack of stimulation and decline.

Quality of life matters far more than longevity. Capacity in the system needs to be increased (which will also benefit the NHS acute care capacity). Caring needs to be a viable profession with practical salary and hours to retain workers. We also need to be realistic about mortality. No one is immortal.

I also agree with this. I think there is an issue in this country with the elderly with dementia or severely limited mobility being shut away behind closed doors, and people not really knowing the reality.

[quote ronniz]@foxgoosefinch no I don't, why is it relevant that countries like Ireland & Poland has younger populations? Are you just assuming young people from those countries want to move to the UK? over other European countries? [/quote]
Actually Eastern European countries have the fastest aging populations in Europe. US stealing their young workers isn't ideal.

Amalfa

We need to legalise euthanasia imo. When people are terminally ill or have dementia they should be able to go to sleep as peacefully as animals do“

Agree.

@awesomekilick we have the same issue with my stepdad. He is having dialysis 4 times a week (at massive expense to the taxpayer), he's had a stroke leaving him completely bedbound, he's got MRSA, a dodgy heart and dementia.
Yet a doctor thought it was appropriate to brink him back from the brink when he had Covid at the start of the pandemic.

He's in a state that no one should be in. Plus it's bankrupting the family paying for the care. The carers hate him because with the slight movement he has left in one arm he throws faeces around the room and at them. He's even done it at dialysis and instead of taking him off and sending him home, they cancelled someone's appointment and put him on another machine after they cleaned him up. That person whose machine he took was probably far more deserving of that machine based on quality of life.
No one deserves to live like he does now. He should have been allowed to die.

Perhaps it could be part of an advance directive; ie when my dementia reaches this stage please kindly euthanise me. If that was ever legal I would absolutely request it.

But what if when it comes to that stage you're still happy and enjoying life? You should be killed anyway, because that's what you previously said you wanted?

The problem is it's really easy when you're young and healthy to look at an elderly and ill person and say 'I wouldn't want to live like that'. It's hypothetical. When you're actually in the situation you might find that the will to live, and the pleasure you can still find in life, is bigger than you imagine.

@Cucumberpitta the difficulty is deciding if that option is valid.

When I was in my 20s I might have thought that having to think hard about what day of the week I was on or accidentally calling the dog by my DS's name was a sign of the beginning of the end.

Now in my 50s I do these things all the time, I dont feel that I am quite ready to depart.

The problem is that the decision of when is the right time to die is so often a decision made in hindsight.

DMiL was able to get pleasure from talking about her family even when she couldnt recognise them in person.

@Purplewithred I like your ideal world suggestions. To be honest I think they sound very sensible and not all unrealistic. So much depends on having proper conversations with family, medical professionals. In my mind this is no different from the thought processes needed to be gone through when making wills.

Cucumberpitta - so you think it wouldn’t help if young skilled workers from eg. Eastern European countries were able to come here and work in health and social care for a few years?

What’s your solution? It’s not just about population demographics - it’s also about relative assets. Today in the U.K. the vast majority of housing wealth is held by people over 50. Younger workers pay high housing costs in large mortgages and rents, often directly to the older population in terms of rental costs. They also face low inflation which puts a long term ceiling on their disposable income, so they have little flexibility to pay more in tax. They also (in order to support their high housing costs) have to take jobs that pay enough to support high mortgages and rents.

Whereas, the over-50s hold not only the majority of housing assets, but also have access to higher pension assets than the upcoming generations will be able to access.

Solutions? Well, either the older generations will need to liquidate assets in order to pay a lot more for expensive health and social care (so there will be an inflationary pressure on health and social care costs), or additional labour will need to be found, or both.

Most likely, older generations will need to accept either a collapse in housing assets and/or liquidating their assets to pay for care; or low or no care - any way round, it isn’t sustainable for them to hold the majority of asset and pension wealth, whilst also expecting care to be given by a smaller proportion of income-stressed younger workers. 🤷‍♀️

The problem is it's really easy when you're young and healthy to look at an elderly and ill person and say 'I wouldn't want to live like that'. It's hypothetical

All my older relatives who aren't completely older look at older people in hospital & care homes & say they don't want to end up the same.

@foxgoosefinch why do you think those workers will want to come here though?

I agree that we can't put anymore burden on the young & that older people will need to contribute more but it's just not a popular view.

All my older relatives who aren't completely older look at older people in hospital & care homes & say they don't want to end up the same.

But again, there's a huge difference between 'I hope that doesn't happen to me/I don't want that to happen to me' and 'it has happened to me, kill me now'.

And before anyone says it’s always been like that - no, in the past it was usual for housing asset wealth to be mainly held by workers, and not by pensioners, for example. It’s a very recent historical development to have a population where the vast majority of housing wealth is held by those who no longer work.

it isn’t sustainable for them to hold the majority of asset and pension wealth, whilst also expecting care to be given by a smaller proportion of income-stressed younger workers.

It isn't hence my worry as birth rates will keep declining due to cost of living. China has bought in the 3 child policy but I'm not sure that women want that now. But there just isn't the appetite for people to pay more for their care.

@HardbackWriter I agree there is a difference but my point is it's not just the healthy & young. It's fears and a lack of control.

@foxgoosefinch

Cucumberpitta - so you think it wouldn’t help if young skilled workers from eg. Eastern European countries were able to come here and work in health and social care for a few years?

What’s your solution? It’s not just about population demographics - it’s also about relative assets. Today in the U.K. the vast majority of housing wealth is held by people over 50. Younger workers pay high housing costs in large mortgages and rents, often directly to the older population in terms of rental costs. They also face low inflation which puts a long term ceiling on their disposable income, so they have little flexibility to pay more in tax. They also (in order to support their high housing costs) have to take jobs that pay enough to support high mortgages and rents.

Whereas, the over-50s hold not only the majority of housing assets, but also have access to higher pension assets than the upcoming generations will be able to access.

Solutions? Well, either the older generations will need to liquidate assets in order to pay a lot more for expensive health and social care (so there will be an inflationary pressure on health and social care costs), or additional labour will need to be found, or both.

Most likely, older generations will need to accept either a collapse in housing assets and/or liquidating their assets to pay for care; or low or no care - any way round, it isn’t sustainable for them to hold the majority of asset and pension wealth, whilst also expecting care to be given by a smaller proportion of income-stressed younger workers. 🤷‍♀️

I understand and agree with what you are saying, except, it seems a bit 'Nationalist' to try and find a solution for the UK by worsening the very same problem for our neighbours.

Also, many who come here stay for much longer than a few years so it's not like we're just borrowing them for a little bit.

[quote ronniz]@foxgoosefinch why do you think those workers will want to come here though?

I agree that we can't put anymore burden on the young & that older people will need to contribute more but it's just not a popular view. [/quote]
Historically they have wanted to, even for a few years, because of the income differentials between different countries, as well as for qualifications and lifestyle. Then they return to their own countries.

The only feasible alternative to short term EU migration is longer term non-EU migration, if you want extra labour - otherwise you need to make do with the workers you have.

@foxgoosefinch I agree so why would people from other countries choose to come. I know quite a few people (medical professionals) who have gone to NZ & Canada despite good salaries for better salaries & crucially a better quality of living. Care work doesn't offer that.

Yes historically it has been beneficial (my parents are immigrants) but it's not so attractive now & it certainly won't be in the future.

[quote GnomeDePlume]@Cucumberpitta the difficulty is deciding if that option is valid.

When I was in my 20s I might have thought that having to think hard about what day of the week I was on or accidentally calling the dog by my DS's name was a sign of the beginning of the end.

Now in my 50s I do these things all the time, I dont feel that I am quite ready to depart.

The problem is that the decision of when is the right time to die is so often a decision made in hindsight.

DMiL was able to get pleasure from talking about her family even when she couldnt recognise them in person.

@Purplewithred I like your ideal world suggestions. To be honest I think they sound very sensible and not all unrealistic. So much depends on having proper conversations with family, medical professionals. In my mind this is no different from the thought processes needed to be gone through when making wills.[/quote]
I don't think you can make a judgment on quality of life for someone with advanced dementia (and I'm talking about an advance directive asking for euthanasia when your dementia reaches a certain stage, not when you're starting to be a bit.morw forgetful) unless you either work with them as a carer or if you've stayed with them in their home or care home for 38 hours.
Yes, there are moments of pleasure. But these are almost always outweighed by the distress of confusion, being doubly incontinent etc etc.

I wouldn't let my dog go through this so why would I want it for myself.

@HardbackWriter

Perhaps it could be part of an advance directive; ie when my dementia reaches this stage please kindly euthanise me. If that was ever legal I would absolutely request it.

But what if when it comes to that stage you're still happy and enjoying life? You should be killed anyway, because that's what you previously said you wanted?

The problem is it's really easy when you're young and healthy to look at an elderly and ill person and say 'I wouldn't want to live like that'. It's hypothetical. When you're actually in the situation you might find that the will to live, and the pleasure you can still find in life, is bigger than you imagine.

Have you worked as a carer for anyone with advance dementia?

Actually a lot of staff from EU countries came here to work in healthcare, nursing, medical training - as you’ll know if you’ve stayed in a hospital in recent years. Largely because of good training, flexible work and decent pay compare to home countries, as well as the lifestyle and culture. We used to be quite a desirable country to live in, believe it or not!

There’s been a huge exodus of EU workers in healthcare since Brexit, which has put additional pressure on the NHS.

Overall, there isn’t much scope in the medium to long term for anything other than a slow slide of downwards housing values, decreasing living standards, poor and getting worse health and social care, and increasing social unrest as the older generations gradually realise they can’t have what they want and gradually let go of some of their wealth to fund it. But it will be a long slow slide of unpleasant decline IMO.

We did but not so much now.

But it will be a long slow slide of unpleasant decline IMO

This is my fear